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1.
Indian J Lepr ; 2023 Jun; 95: 147-151
Article | IMSEAR | ID: sea-222645

RÉSUMÉ

It is well known that Mycobacterium leprae tends to target the cooler parts of the body and can involve the oral cavity. Despite this, macrocheilia - a condition where the lips become enlarged - caused by leprosy is rarely documented. There are few reported cases of leprous macrocheilia in India. We present a unique case of an elderly woman with borderline tuberculoid leprosy in type I reaction who developed leprous macrocheilia.

2.
Article | IMSEAR | ID: sea-233308

RÉSUMÉ

Background: Type 2 diabetes mellitus (T2DM) significantly increases morbidity and mortality from cardiovascular disease. The present study was conducted to know the effect of thiazolidinedione and SGLT2 inhibitor on glycemic control, blood pressure and lipid profile and effect on cardiovascular mortality in T2DM. Methods: A total 80 patients of aged ?40 years with T2DM were included and divided into 4 groups based on ongoing treatment i.e., (lifestyle modification + Tab metformin 500mg BD) + 1) Tab metformin 500mg; 2) Tab dapagliflozin 10mg OD; 3) Tab pioglitazone 15mg OD; 4) Tab pioglitazone 15mg OD + Tab Dapagliflozin 10mg OD. Results: The change in FBS, PLBS and HbA1C from pre-intervention to post-intervention was highest in the patients with DAPA + pioglitazone group followed by patients with pioglitazone group then the patients with DAPA group and lowest in patients with metformin group. There was a statistically significant difference between them, (p<0.001). The weight reduction was highest in the patients with DAPA 10mg group followed by patients with metformin group, (p<0.001). The change in SBP, DBP and change in lipid profile (triglyceride and cholesterol, LDL and HDL) from pre-intervention to post-intervention was highest in the patients with DAPA+ pioglitazone group. This change was statistically significant (p<0.001). Conclusions: The combination of pioglitazone and dapagliflozin not only helped in glycemic control but also had reduction in blood pressures, improvement in the lipid profile and caused slight weight reduction. There were no major adverse drug reactions, and no MACE was observed during the study. Hence this combination of pioglitazone and dapagliflozin may reduce the cardiovascular mortality (which needs longer duration study).

3.
Article | IMSEAR | ID: sea-233132

RÉSUMÉ

Background: Type 2 diabetes mellitus (T2DM) significantly increases morbidity and mortality from cardiovascular disease. The present study was conducted to know the effect of thiazolidinedione and SGLT2 inhibitor on glycemic control, blood pressure and lipid profile and effect on cardiovascular mortality in T2DM. Methods: A total 80 patients of aged ?40 years with T2DM were included and divided into 4 groups based on ongoing treatment i.e., (lifestyle modification + Tab metformin 500mg BD) + 1) Tab metformin 500mg; 2) Tab dapagliflozin 10mg OD; 3) Tab pioglitazone 15mg OD; 4) Tab pioglitazone 15mg OD + Tab Dapagliflozin 10mg OD. Results: The change in FBS, PLBS and HbA1C from pre-intervention to post-intervention was highest in the patients with DAPA + pioglitazone group followed by patients with pioglitazone group then the patients with DAPA group and lowest in patients with metformin group. There was a statistically significant difference between them, (p<0.001). The weight reduction was highest in the patients with DAPA 10mg group followed by patients with metformin group, (p<0.001). The change in SBP, DBP and change in lipid profile (triglyceride and cholesterol, LDL and HDL) from pre-intervention to post-intervention was highest in the patients with DAPA+ pioglitazone group. This change was statistically significant (p<0.001). Conclusions: The combination of pioglitazone and dapagliflozin not only helped in glycemic control but also had reduction in blood pressures, improvement in the lipid profile and caused slight weight reduction. There were no major adverse drug reactions, and no MACE was observed during the study. Hence this combination of pioglitazone and dapagliflozin may reduce the cardiovascular mortality (which needs longer duration study).

4.
Article | IMSEAR | ID: sea-195633

RÉSUMÉ

Background & objectives: Numerous studies have highlighted the regressive and immiserating impact of out-of-pocket (OOP) health spending in India. However, most of these studies have explored this issue at the national or up to the State level, with an associated risk of overlooking intra-State diversities in the health system and health-seeking behaviour and their implication on the financial burden of healthcare. This study was aimed to address this issue by analyzing district level diversities in inequity, financial burden and impoverishing impact of OOP health spending. Methods: A household survey of 62,335 individuals from 12,134 households, covering eight districts across three States, namely Gujarat, Haryana and Rajasthan was conducted during 2014-2015. Other than general household characteristics, the survey collected information on household OOP [sum total of expenditure on doctor consultation, drugs, diagnostic tests etc. on inpatient depatment (IPD), outpatient depatment (OPD) or chronic ailments] and household monthly consumption expenditure [sum total of monthly expenditure on food, clothing, education, healthcare (OOP) and others]. Gini index of consumption expenditure, concentration index and Kakwani index (KI) of progressivity of OOP, catastrophic burden (at 20% threshold) and poverty impact (using district-level poverty thresholds) were computed, for these eight districts using the survey data. The concentration curve (of OOP expenditure) and Lorenz curve (of consumption expenditure) for the eight districts were also drawn. Results: The distribution of OOP was found to be regressive in all the districts, with significant inter-district variations in equity parameters within a State (KI ranges from ?0.062 to ?0.353). Chhota Udepur, the only tribal district within the sample was found to have the most regressive distribution (KI of ?0.353) of OOP. Furthermore, the economic burden of OOP was more pronounced among the rural sample (CB of 19.2% and IM of 8.9%) compared to the urban sample (CB of 9.4% and IM of 3.7%). Interpretation & conclusions: The results indicate that greater decentralized planning taking into account district-level health financing patterns could be an effective way to tackle inequity and financial vulnerability emerging out of OOP expenses on healthcare.

6.
Br J Med Med Res ; 2015; 10(12):1-8
Article de Anglais | IMSEAR | ID: sea-181868

RÉSUMÉ

Objective: This cross-sectional study was design to investigate prevalence and risk factors of generalized anxiety disorder in traumatic brain injury (TBI). Materials and Methods: The Group studied consists of 204 patients of mild and moderate TBI between 14- days to one-year post injury. Demographic characteristics of the participants were assessed on a self-designed semi structured performa. Interviews focused on assessment of severity of TBI, generalized anxiety disorder (GAD) and quality of life (Qol) using GCS, GAD-7 and WHOBREF-QOL respectively. Results: Total 204 patients were included. 11.76% participants were found to have generalized anxiety disorder. None of the demographic variables were associated with GAD except injury severity. Mild TBI patient (75.00%) had higher occurrence of GAD than the moderate cases (25.00%). GAD patients also had poor Qol than those without GAD in all domains except physical and social health domain. Neuroanatomical localization was also correlated with GAD. Left frontal contusions were the most common (37.50 %) lesions associated with GAD. Conclusion: GAD is commonly associated, yet under diagnosed clinical entities in head injury and have tremendous impact in overall outcome measures. Every patient of head injury warrants psychiatric evaluation and concomitant treatment if required to ensure the attainment of not only neuroanatomical intact but overall productive and qualitative life vindicating the holistic and multidisciplinary treatment approach.

7.
Article de Anglais | IMSEAR | ID: sea-157677

RÉSUMÉ

Deficiency and excess amount of trace elements play an important role in several well recognized diseases, studies are going on to establish their role in schizophrenia. Selenium and other trace elements are indispensable components for certain enzymes responsible for various metabolic processes in different tissues including the brain as they play important functional roles in peripheral and central nervous systems. Objectives: In this study, we examined the levels of selenium in serum of patients of schizophrenia and compare them with normal healthy controls. Selenium was also measured in acute and chronic stage of schizophrenia categorized on the basis of PANSS score and correlated by Spearman’s Correlation Coefficient (ρ) in total cases, acute cases and chronic cases. Method: The study population comprised 150 patients and 150 age matched controls. We measured levels of Selenium by AAS (Atomic Absorption Spectrophotometer). Results: We found that selenium levels were significantly lower in patients with schizophrenia than in the control group. The levels of micronutrients studied were also correlated with disease severity and duration but found non-significant relation. Conclusion: Evaluation of selenium levels in patients with schizophrenia could prove useful. There may be role of Selenium in the pathogenesis and course of Schizophrenia and new therapeutic approaches warrants further study.


Sujet(s)
Adolescent , Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Échelles d'évaluation en psychiatrie/statistiques et données numériques , Psychométrie , Schizophrénie/sang , Schizophrénie/classification , Schizophrénie/épidémiologie , Schizophrénie/étiologie , Sélénium/analyse , Sélénium/sang , Sélénium/déficit , Spectrophotométrie atomique , Jeune adulte
8.
Article de Anglais | IMSEAR | ID: sea-178419

RÉSUMÉ

As oral cavity is an integral part of general health, persistent and unrelenting stress often becomes a danger affecting the oral health and overall health causing various psychosomatic disorders. Present study aimed to determine the prevalence of oral mucosal lesions and bruxism in psychiatric patients dependent on psychotropic drugs. Dental examination was done and questionnaire administered to 150 psychiatric patients and 150 control participants. In dental examination recurrent apthous stomatitis, burning mouth syndrome, oral lichen planus, bruxism, temporomandibular disorders were evaluated. Results showed that psychiatric patients had higher prevalence of bruxism, oral mucosal lesions in general, than the control group.

9.
Indian J Med Microbiol ; 2011 Apr-June; 29(2): 152-157
Article de Anglais | IMSEAR | ID: sea-143799

RÉSUMÉ

Purpose: Trichomonas vaginalis, a protozoan parasite, is the causative agent of human trichomoniasis, the most common non-viral sexually transmitted disease. The infection encompasses from a complete asymptomatic presentation to severe sequelae; yet, the virulence markers have been poorly understood. It is suggested that the presence of Trichomonas vaginalis virus (TVV) in T. vaginalis may have an impact on its virulence, and its relatedness to in vitro metronidazole resistance has been reported. The aim of the study was to assess the presence of TVV in fresh and Long -Term Cultivated ( LTC) maintained T. vaginalis isolates from symptomatic (S) and asymptomatic (AS) Indian women and its relatedness, if any, with symptomatology and in vitro drug sensitivity. Materials and Methods: One thousand women (537 S and 463 AS) were screened for the presence of T. vaginalis by wet smear and culture examination of vaginal swab and urine sample. Fresh and LTC (6 months-2 years) maintained 15 isolates each from 15 S and 15 AS women were subjected to agarose gel electrophoresis following total cellular RNA extraction to evaluate the presence of double stranded (ds) RNA viral infection. The susceptibility of isolates to metronidazole was determined in vitro. Results: On agarose gel electrophoresis, three bands (5.5, 2.5 and 1.5 kb) were observed in all the 30 fresh isolates from 15 S and 15 AS women and only in 7 LTC isolates from 3 S and 4 AS women. All the fresh isolates harbouring TVV were found to be sensitive to metronidazole in vitro irrespective of the symptomatology of subjects, and out of seven LTC isolates harbouring TVV, six were sensitive to metronidazole and one showed borderline resistance. Conclusions: The results suggest that the presence of TVV alone may not be a virulence marker and loss of TVV on LTC appears to be related to drug resistance. The T. vaginalis Indian isolates are sensitive to metronidazole.


Sujet(s)
Adolescent , Adulte , Antiprotozoaires/pharmacologie , Maladies asymptomatiques , Résistance aux substances , Femelle , Humains , Inde , Métronidazole/pharmacologie , Tests de sensibilité parasitaire , Virus à ARN/génétique , Virus à ARN/isolement et purification , ARN double brin/génétique , Vaginite à Trichomonas/parasitologie , Trichomonas vaginalis/isolement et purification , Jeune adulte
10.
Article de Anglais | IMSEAR | ID: sea-25592

RÉSUMÉ

BACKGROUND & OBJECTIVE: Very high levels of adherence are required for ART to be effective. There is limited information available from India on adherence to ART and its predictors. We carried out this study to examine adherence levels and to explore the factors associated with adherence among PLHA receiving ART in India. METHODS: Using a cross-sectional study design 310 HIV+ patients receiving ART (252 paying out-of-pocket; 58 free via employee-insurance programme) were interviewed from Pune and Delhi health facilities, using a semi-structural questionnaire. RESULTS: The median age for patients was 36 yr. The median time from diagnosis of HIV-infection was 34.5 months, median time on ART was 16 months and median CD4 cell count at start of ART was 110 cells/microl. 98 per cent of the respondents were using a non protease inhibitor (PI) treatment regimen. Mean 4-day adherence was 93 per cent. Adherence was lower over longer periods of recall: 20 per cent reported missed does over the past 7 days; 33 per cent reported ever missing a full day's medications and 16 per cent had a treatment interruption of more than 7-days at least once. On univariate analysis less than university education, being unemployed, obtaining free treatment, severe depression, baseline CD4 count>200/microl, hospitalization >2 times, having moderate to severe side-effects and taking 4 or more medicines were associated with lower adherence (<90%). However, only obtaining free treatment (adjusted OR, 4.05, 95% CI 1.42-11.54, P=0.009) and severe depression (adjusted OR 4.48, 95% CI 1.64-12.27, P=0.003) were associated with lower adherence in multivariate analysis. INTERPRETATION & CONCLUSION: Although the overall adherence was high, lower levels of adherence were documented among patients receiving free ART. Provision of free treatment without adequate patient preparation and adherence support may compromise the success of ART scale up programmes. Early diagnosis and management of depression need special focus.


Sujet(s)
Adulte , Sujet âgé , Agents antiVIH/usage thérapeutique , Études transversales , Femelle , Infections à VIH/traitement médicamenteux , Humains , Mâle , Adulte d'âge moyen , Observance par le patient
12.
Indian J Pediatr ; 2001 Apr; 68(4): 323-6
Article de Anglais | IMSEAR | ID: sea-83774

RÉSUMÉ

The study was conducted on 957 school children using Rutter B scale which was to be completed by the class teachers in Ludhiana, India. One hundred and forty-one children (14.6%) scored more than 9 points and were included in the second part of the study. An equal number of sex matched children scoring less than 9 points served as controls. Both these groups were called for an interview with a child psychiatrist along with their parents. Only 117 and 124 children turned up and were included in the analysis. Based on the screening instrument results and parental interview, 45.6% of the children were estimated to have behavioural problems, of which 36.5% had significant problems. It was noticed that neither the screening instrument nor the interview was able to detect all the problems. Scholastic under-achievement was found to be associated with maximum problems. Scholastic under-achievement can be a useful starting point of identifying children with behavioural problems. Close cooperation between school teachers, parents, and health care providers is essential to ensure healthy development of children.


Sujet(s)
Enfant , Troubles du comportement de l'enfant/épidémiologie , Femelle , Humains , Inde/épidémiologie , Entretiens comme sujet , Mâle , Prévalence , Population urbaine
13.
Indian J Biochem Biophys ; 2000 Dec; 37(6): 498-505
Article de Anglais | IMSEAR | ID: sea-28586

RÉSUMÉ

Treatment of diphenyl ether herbicide acifluorfen-Na (AF-Na) to intact cucumber (Cucumis sativus L cv Poinsette) seedlings induced overaccumulation of protoporphyrin IX in light (75 mumole m-2 s-1). The extra-plastidic protoporphyrin IX accumulated during the light exposure disappeared within two hours of transfer of acifluorofen-treated seedlings to darkness. The dark disappearance was due to re-entry of migrated protoporphyrin IX into the plastid and its subsequent conversion to protochlorophyllide. In light, protoporphyrin IX acted as a photosensitizer and caused generation of active oxygen species. The latter caused damage to the cellular membranes by peroxidation of membrane lipids that resulted in production of malondialdehyde. Damage to the plastidic membranes resulted in damage to photosystem I and photosystem II reactions. Dark-incubation of herbicide-sprayed plants before their exposure to light enhanced photodynamic damage due to diffusion of the herbicide to the site of action. Compared to control, in treated samples the cation-induced increases in variable fluorescence/maximum fluorescence ratio and increase in photosystem II activity was lower due to reduced grana stacking in herbicide-treated and light-exposed plants.


Sujet(s)
Cucumis sativus/effets des médicaments et des substances chimiques , Herbicides/pharmacologie , Nitro-benzoates/pharmacologie , Stress oxydatif , Protoporphyrines/pharmacologie
14.
Article de Anglais | IMSEAR | ID: sea-118183

RÉSUMÉ

BACKGROUND: Most infants with congenital Toxoplasma gondii infection have no symptoms at birth but few may develop retinal diseases or neurological abnormalities later in life. The presence of significant titres of antitoxoplasma antibodies in women in the reproductive age group indirectly indicates that Toxoplasma gondii is the cause of such congenital abnormalities and also sporadic abortions in some women. METHODS: We did a retrospective analysis of antitoxoplasma antibodies detected by indirect haemagglutination assay, in women with bad obstetrical history and in newborns clinically suspected of congenital toxoplasmosis during 1981-91. RESULTS: A significant increase in seropositivity in women and newborns was seen during 1989-91 as compared to 1981-88. More seropositive patients were recorded between April-June and October-December. However, no significant correlation could be observed between rising incidence of seropositivity and the seasonal distribution or age of women. CONCLUSION: Epidemiological studies are required to ascertain the reason for the increasing trend of toxoplasma seropositivity and to suggest appropriate control strategies as it is possible to prevent congenital infection.


Sujet(s)
Adolescent , Adulte , Animaux , Anticorps antiprotozoaires/sang , Pays en voie de développement , Femelle , Humains , Inde/épidémiologie , Nouveau-né , Grossesse , Complications parasitaires de la grossesse/épidémiologie , Grossesse à haut risque , Études rétrospectives , Toxoplasma/immunologie , Toxoplasmose/épidémiologie , Toxoplasmose congénitale/épidémiologie
15.
Article de Anglais | IMSEAR | ID: sea-19991

RÉSUMÉ

Copper levels were estimated in the uterine flushings in 15 copper 'T' 200 device acceptors. There was a statistically significant difference in the preinsertion and one week post insertion values (P < 0.001). This also corresponded to a high level of generation of reactive oxygen species. The levels of reactive oxygen species were similar to preinsertion values at 4 and 12 wk. The copper values declined over the 3 months but were still higher at 12 wk as compared to preinsertion levels and this difference was statistically significant. Hence addition of copper to the intrauterine device besides enhancing the contraceptive efficacy, perhaps also plays an important role in microbicidal activity and helps in overcoming the infection introduced at the time of insertion.


Sujet(s)
Adulte , Cuivre/analyse , Femelle , Humains , Dispositifs intra-utérins au cuivre , Irrigation thérapeutique , Espèces réactives de l'oxygène/analyse , Utérus/métabolisme
16.
Indian J Med Sci ; 1992 Jun; 46(6): 169-73
Article de Anglais | IMSEAR | ID: sea-68592

RÉSUMÉ

Spasticity and flexor spasms can be most incapacitating in SCI victims. Muscle relaxants, physiotherapy and elimination of triggering factors must be tried before opting for peripheral surgery or alcohol block. The choice of alcohol block or peripheral surgery depends in whether damage to the spinal cord is complete or incomplete. Results of both the procedures are satisfactory in rightly chosen patients. Alcohol block is a simple, safe and effective method of treating spasticity in the patients of complete paraplegia. The effect is immediate and almost permanent. However, alcohol block is contra-indicated in the patients of incomplete paraplegia where peripheral surgery is a better choice.


Sujet(s)
Tendon calcanéen/chirurgie , Éthanol/administration et posologie , Hanche/innervation , Humains , Injections rachidiennes , Genou/chirurgie , Spasticité musculaire/étiologie , Muscles/chirurgie , Traumatismes de la moelle épinière/complications , Tendons/chirurgie , Résultat thérapeutique
17.
J Indian Med Assoc ; 1992 Mar; 90(3): 57-9
Article de Anglais | IMSEAR | ID: sea-98821

RÉSUMÉ

A stratified random sample of 10,263 school-going children in the age group of 6-16 years from government and private schools were screened for the prevalence of rheumatic fever, rheumatic heart diseases and congenital heart diseases. Fourteen children were found to have rheumatic heart disease with valvular lesions either single or in combination eg, pure mitral stenosis (6 cases), mitral regurgitation (4 cases), combined mitral stenosis and mitral regurgitation (3 cases) and aortic and mitral regurgitation (one case). Eight children had congenital heart diseases in the form of ventricular septal defect (3 cases), atrial septal defect (2 cases), patent ductus arteriosus (2 cases) and congenital bicuspid aortic valve (one case) while none had active rheumatic fever.


Sujet(s)
Adolescent , Enfant , Femelle , Cardiopathies congénitales/épidémiologie , Humains , Inde/épidémiologie , Mâle , Prévalence , Rhumatisme cardiaque/épidémiologie
18.
Indian J Ophthalmol ; 1992 Jan-Mar; 40(1): 5-8
Article de Anglais | IMSEAR | ID: sea-72545

RÉSUMÉ

Pilocarpine and Homatropine are the drugs having known effect on the depth of anterior chamber. The purpose of this study was to demonstrate the time of onset, peak effect and its duration of action as well as shallowing/deepening of the anterior chamber, after single instillation of pilocarpine 2% or homatropine bromide 2%, topically in one eye. Also we tried to see if there is any effect on the contralateral eye, due to systemic absorption of pilocarpine, homatropine after topical instillation of the drug in one eye. Pilocarpine causes a measurable shallowing of the anterior chamber with onset of effect with in 20 minutes and a peak in 60 minutes, the average narrowing being 0.26 mm. (range 0.20-0.29 mm.). Homatropine has a measurable deepening effect on the anterior chamber, due to axial flattening of the lens because of cycloplegia, with a range of 0.33 to 0.36 mm. In 70% of the cases the effect passes away with in 24 hours., but in 30% it comes to normal in 48 hours.


Sujet(s)
Adulte , Chambre antérieure du bulbe oculaire/effets des médicaments et des substances chimiques , Humains , Cristallin/effets des médicaments et des substances chimiques , Adulte d'âge moyen , Solutions ophtalmiques , Parasympatholytiques/pharmacocinétique , Pilocarpine/pharmacocinétique , Tropanes/pharmacocinétique
19.
Article de Anglais | IMSEAR | ID: sea-63712

RÉSUMÉ

The efficacy of parenteral metoclopramide in the control of active variceal bleeding was assessed in a prospective, randomized, double blind, placebo controlled trial. Patients with portal hypertension due to different etiologies (cirrhosis, non cirrhotic portal fibrosis and extrahepatic portal venous obstruction) with endoscopically documented active variceal bleeding entered the study. Forty nine consecutive patients were randomized after pre-entry stratification for Child's scores. Intravenous metoclopramide (20 mg) or 2 ml dextrose was administered in all patients while the first endoscopy documented an active variceal bleeding. All patients were subjected to a second endoscopy 15 minutes later to determine control of bleeding. Rebleeding rate, transfusion requirement, adverse effects and mortality were analysed. Twenty of the 25 patients treated with metoclopramide stopped bleeding compared to 5 of 24 in the control group (p less than 0.05). Rebleeding occurred in 4 of 20 in the metoclopramide group and 4 of 5 in the control group within 72 hours (p less than 0.05). The number of patients requiring blood transfusion (10 vs 16) and the transfusion requirement (1.8 +/- 2.2 vs 3.6 +/- 2.1 units) were significantly lower (p less than 0.01) in the metoclopramide group than in the control group. Mortality was similar and there were no complications due to therapy. We conclude that intravenous metoclopramide is a safe and effective agent for the control of acute esophageal variceal bleeding.


Sujet(s)
Adolescent , Adulte , Transfusion sanguine , Méthode en double aveugle , Varices oesophagiennes et gastriques/traitement médicamenteux , Femelle , Hémorragie gastro-intestinale/traitement médicamenteux , Humains , Mâle , Métoclopramide/usage thérapeutique , Adulte d'âge moyen , Études prospectives , Sclérothérapie
20.
Article de Anglais | IMSEAR | ID: sea-25809

RÉSUMÉ

Characterization of T. vaginalis strains isolated from symptomatic and asymptomatic subjects was done by isoenzyme analysis. The pathogenicity of these isolates was checked in mouse model and in vivo drug susceptibility was determined. The isolates from symptomatic and asymptomatic individuals could not be grouped on the basis of isoenzyme analysis alone. All the strains except one, were pathogenic for mice, and metronidazole (50 mg/kg body weight) was effective in protecting the mice from T. vaginalis infection.


Sujet(s)
Adulte , Animaux , Femelle , Humains , Isoenzymes/analyse , Souris , Vaginite à Trichomonas/parasitologie , Trichomonas vaginalis/classification , Virulence
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